Pattern of occlusive disease in lower extremity arteries in patients qualifying for revascularization in a North Central Province tertiary care centre in Sri Lanka

Abstract

Introduction: In Sri Lanka many patients with the occlusive arterial disease [OAD] undergo revascularization. The patterns of OAD vary with the underlying risk factors, however, there is a paucity of data regarding this in Sri Lankan patients. Only one study reported the pattern of OAD among patients undergoing angioplasty in Sri Lanka. This study used conventional or catheter angiograms. There were no studies describing the patterns of OAD based on computerized tomographic angiography [CTA] imaging reported in Sri Lanka earlier. This study describes the CTA-based pattern of OAD among patients admitted for intervention at the Teaching Hospital Anuradhapura [THA]. Methods: This study was done at the vascular and transplant unit of THA. Patients with critical limb ischemia [ulcer, gangrene, rest pain] and disabling claudication were included. Data on patient demography, comorbid diseases, and the pattern of arterial occlusion were analysed. Results: 100 patients with 81 [81%] males were included. The mean age was 67.6 years [53-83].60 had ulcers, 25 gangrene, 10 rest pain and 5 had disabling claudication. 63 [63%] were smokers. diabetes mellitus, hypertension, ischemic heart disease, heart failure and chronic kidney disease were present in 65 [65%], 47, 25, 11 and 13 respectively. Distal vascular disease [anterior tibial- AT - 55 and posterior tibial - PT - 44] was present in 65 [65%]. Iliac, Femoral [common femoral – CFA and superficial femoral - SFA] disease were present in 15 [15%] and 57 [57%] respectively. 28 [28%] had isolated distal arterial disease. The distal disease was not significantly associated with diabetes mellitus [p - 0.39]. Conclusion: Distal occlusive arterial disease is the commonest followed by femoral disease. This study does not show an association between diabetes mellitus and distal disease, contrary to the popular belief. Further countrywide studies with larger study populations are needed to come to a final conclusion.